People in the Amish community have been using “The New Concept in Treating Burns” and their experience is recounted in a little booklet by that title. It is a compilation of articles, testimonials, and letters to the editor of a monthly newspaper Plain Interests, published in Millersburg PA.

The treatment, involving B&W ointment and dressings of scalded burdock leaves, was developed by John Keim, an Amish farmer and natural healer. The Amish have a tradition of taking care of their own, and they try to avoid hospitals whenever possible. In the booklet, they even recommend treating hip fractures at home without surgery. (Which, after all, is what we did before we had hospitals and surgery).

They claim that with the B&W burn treatment:

Painful burns are rendered non-painful.

Healing is faster.

Painful debridement is not necessary.

Skin grafting is not necessary.

Scarring seldom occurs.

Iatrogenic harm from hospitals is avoided.

Patients can be treated at home at much less expense.

According to Keim, with his method it seldom takes more than seven days to get a completely new skin cover on second and third degree burns, and in over two decades he never had an infection. He saw only 2 cases of scarring, and they were minimal. He does not charge for his services.

The ointment and a booklet by John Keim are available on this website. The ointment costs between $1.50 and $3.00 per ounce, depending on the amount purchased.

I have been unable to find how he decided which ingredients to include and how much of each to use, but I did find this example of his methods of discovery:

When he was in dire need for a remedy to treat the burns on his own son, he had gone to the woods to meditate and seek Divine guidance. In due time, his attention was drawn to some nice, big plantain leaves right before him which he believed would serve as an ideal non-stick barrier between the salve he had applied to his son’s body and the gauze body wrap. It worked, but later, it was discovered that burdock leaves are more effective, although plantain leaves are still used under certain circumstances.

Some of the ingredients (aloe vera, lobelia) – reduce inflammation. Several of them are inert emollients. I’m puzzled as to why comfrey is included, since the Natural Medicines Comprehensive Database warns that it should only be used on unbroken skin.

The main ingredient, and probably the active ingredient, is honey. This is nothing new. Honey was recommended for burn treatment in ancient Egyptian papyrus medical texts. There has been a recent resurgence of interest in honey, especially Manuka honey, for which special claims have been made.

There is some research to support honey for burns. One recent study compared honey to conventional treatment for partial thickness burns, and found that the honey-treated burns healed faster with less scarring.

According to this article from the Honey Research Institute (a possibly biased source?)

In the past decade there have been many reports of case studies, experiments using animal models, and randomized controlled clinical trials that provide a large body of very convincing evidence for its effectiveness, and biomedical research that explains how honey produces such good results. As a dressing on wounds, honey provides a moist healing environment, rapidly clears infection, deodorizes, and reduces inflammation, edema, and exudation. Also, it increases the rate of healing by stimulation of angiogenesis, granulation, and epithelialization, making skin grafting unnecessary and giving excellent cosmetic results.

For some or all outcomes honey was superior to all these treatments. Time for healing was significantly shorter for honey than all these treatments. The quality of studies was low. CONCLUSION: Confidence in a conclusion that honey is a useful treatment for superficial wounds or burns is low. There is biological plausibility.

There is insufficient evidence to determine the effect of honey compared with other treatments for burns or in other acute or chronic wound types. Honey may improve healing times in mild to moderate superficial and partial thickness burns compared with some conventional dressings.

I didn’t find any data on honey for third degree burns, and I found evidence that it is ineffective for leg ulcers.

How does plain honey compare to the B&W mixture? We have absolutely no idea, because the B&W treatment has never been scientifically tested.

It is puzzling that in a booklet touting the B&W treatment, they also mention that many other alternative treatments have worked for them, notably lard-and-flour poultices, bag balm, and olive oil. It is their impression that the B&W ointment works best, but that seems to be based on nothing more than opinion. They also say if burdock leaves are not available, you can use any clean leaves, grass or sprouts, scalding them first to provide moisture.

The treatment is not without side effects. In many of the case histories, patients developed rashes, redness, red pimples, prickliness, and hives, interpreted as reactions to burdock leaves or to the ointment itself, requiring substitution or alternation with lettuce leaves, grape leaves, flaxseed paste, bag balm or other natural products. When reactions and pain occur, they use a remedy called Calm Crème. There seems to be a lot of improvisation: B&W is supposed to work so well, but when it doesn’t they resort to trial and error with pretty much anything that occurs to them.

One of the biggest dangers in burns is infection. Keim tells patients not to worry about fever. He says fever is perfectly normal and part of the healing process but you should watch for a bad smell to detect infection. Fever can be treated with vitamin C powder.

In one testimonial a child was hospitalized and got 8 days of conventional burn treatment, then B&W was used when the child was back at home. Guess which got the credit.

One case I found particularly troubling was that of a 14 year old boy with a leg injury. After 5 days of treatment, “the tissue of the leg broke apart, draining so much that a bed pan was kept under the leg to catch the fluids while redressing.” The dressing had a putrefying odor. The calf muscle was no longer attached to the bone on one side and they kept pushing it back into position. Burdock leaves were “drawing too much fluids” so they were replaced with gauze. On day 12 a mixture of milk of magnesia and brown sugar replaced the B&W to help dry up the wound, also colloidal silver was used. Then B&W was used again and he developed an allergic reaction to it. When the healing “came to a halt,” they put him on a diet of lemonade with maple syrup and cayenne pepper, no food. The healing resumed after 5 days of this.

I think he was a very lucky boy to survive both the wound and the treatment. A healthy body has great healing powers and we tend to forget that even without effective treatment people sometimes get well.

Some of the medical advice in the booklet is irresponsible. One parent claims his doctor told them to treat dehydration by sitting the child in lukewarm water for 30 minutes at a time so the body could absorb water through the skin. Another article claims that “Our bodies breathe through the skin” –a man who fell into vat of paint died because his pores were clogged so he couldn’t absorb enough oxygen through his skin. Don’t add sugar to boiling water, as it decomposes the sugar. “Dehydrated children should never be given plain water as this may make their condition worse.” Give juices instead. You can determine if a patient is responding and has “good vitals” by doing one simple test: verifying that his pupils constrict briskly when you shine a light in his eyes.

The testimonials are impressive and they may be onto something, but there are so many unanswered questions! Is the B&W mixture better than just honey? Does it matter what kind of honey you use and whether it is raw or pasteurized? Are all 12 ingredients necessary and are the amounts optimal? Is there something special about burdock leaves? Is it possible that the ointment or the leaves could introduce bacteria or contaminants into the wounds? (The blanching process would not sterilize the leaves). Can we trust a parent’s assessment that the child really had third degree burns over 20% of the body surface and second degree burns over another 10%? Would the patients who healed without skin grafts really have needed skin grafts with conventional treatment? Was the absence of pain due to the treatment or to the fact that third degree burns destroy the nerve endings and are painless?

The testimonials themselves reveal a real danger: treating burns at home can kill people. The booklet describes a 2 ½ year old girl who was treated at home, became unresponsive and died en route to the hospital. They say she died of shock and explain that shock can be from loss of body fluids but in this case they attributed it to the trauma she had gone through. Another 3 year old died of dehydration during treatment. They explain that if they had known then what they know now about using a water/salt/sugar oral rehydration solution, her death might have been prevented. Maybe. It seems certain that both deaths would have been prevented by prompt conventional burn treatment in a hospital.

The Amish have enlisted the cooperation of doctors who are now allowing them to use the B&W treatment in the hospital under supervision. That’s a step in the right direction, because it will allow for detection of dehydration and infection, will permit professional assessment of burn depth and extent, and hopefully will produce accurate case histories that can be published in peer reviewed journals, a step up from the testimonials of uneducated and scientifically naïve parents. But what is really needed is a simple controlled study comparing conventional burn treatment to the B&W/burdock treatment. Until that is done, all we have is speculation, opinion, and guesswork.

I’m a little confused about the following “Dehydrated children should never be given plain water as this may make their condition worse.” being bad medical advice.

I am an avid Triathlete. There is a lot of tribal knowledge surrounding this sport and who knows how much of it is true. Common knowledge is that sport drinks are better than water for “stay hydrated” or maintaining the proper balance of electrolytes an h2o. My understanding is that as you sweat you loose not only water but electrolytes as well. Sport drinks replenish both. A common experience reported among amateurs is after a race being thirsty and drinking water to quench it. This is followed by having to urinate (which is usually clear due to the kidneys filtering out the water you just drank) and further thirst. This cycle is ended as soon as you eat or drink something containing electrolytes.

Some sport drinks even claim to have the perfect balance of electrolytes for osmotic absorption into cells. My drink of choice Nuun (http://www.nuun.com/nuunis/science.html) makes this claim. All I know is that I can drink more of it (than water, Gatorade, or any other sports drink I’ve tried) with less stomach discomfort. It also turns out to be the cheapest sport drink on the market. Of course I fully understand the limits of my anecdotal observations.

Honey? If it’s raw honey, that’s a great way to rub allergens into a burn victim’s skin. A bunch of years ago (I have pretty bad hay fever) a friend gave me some raw honey from his hive to try – and I had a pretty serious allergic reaction from pollen that had contaminated it.

I live up here in amish country and they’re kind of like the taliban only with better marketing.

bharris: My thought would be that since the burn patients are eating (unlike triathletes during a race, it seems), hyponatremia would be very unlikely. I have no medical training, but I teach mountaineering first aid, and this question sometimes comes up. According to what I’ve read, if you’re eating you’re getting enough electrolytes. (This may not be true in some extreme circumstances, like bad burns, so I would be interested in hearing from someone more knowledgeable.)

Looking at Auberach’s _Wilderness Medicine_, he says, “Nonpsychiatric cases [of hyponatremia] are usually associated with enforced water drinking to prevent EHI [exertional heat illness] or with being ‘too conscientious’ in drinking at water stations during a marathon run.” He doesn’t mention food consumption, at least in that section.

Oh, and everything I’ve read in wilderness medicine literature says that sports drinks are usually bad at replacing electrolytes, because the electrolyte content is too low and the sugar content too high. I’m sure there’s variation among sports drinks, though, and quite possibly this is not true of Nuun.

“I live up here in amish country and they’re kind of like the taliban only with better marketing.”

Yeah, that’s pretty much how I feel (near Amish country – actually that might be a lot of places soon because they have large numbers of children) The latest in our area is a group that is fighting the local building code enforcement claiming that installing smoke detectors violates their religious beliefs because they use electricity. I’m hoping the town board stands firm on this one.

As a non-USA resident, the image the Amish project is of a simple, quiet and honest community, living a secluded religious lifestyle. I therefore am not surprised when I hear from people who actually live near them and deal with them that they are superstitious child-abusing nutjobs, like most other religious communities who close themselves off from the world. Why does it still happen in the 21st century ???

Reading this as a microbiologist and with some experience in herbal medicines, the microbiologist cringes at applying leaves (blanched or not) to open wounds. One word: Pseudomonas! It’s a common plant pathogen, and a very opportunistic bacteria in human wounds.

The herbalist is suspicious that there is anything special about this ointment except the marketing: “The ingredients of the B&W ointment are honey, lanolin, olive oil, wheat germ oil, aloe vera gel, wormwood, marshmallow root, comfrey root, white oak bark, lobelia, vegetable glycerin, and beeswax” OK, here’s what they probably do, although you could do the same thing with fewer ingredients … I suspect many of these are on the label for the name factor, not because they do anything special.

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That said, my father treated a bad burn (it was burnt badly enough it couldn’t blister) on my forehead with ice water compresses to kill the pain, followed by spruce tip tea compresses (boiled spruce tips make a sterile solution with lots of polyphenols) and a sterile dressing every day. No scarring, no infection. Late in the healing he used a sterile lanolin ointment to keep the skin soft and un-itchy. That’s exactly 2 ingredients, plus ice and water.

Charon: You are absolutely right about sports drinks. Most of the mainstream sports drinks i.e. Gatorade and Powerade contain way too much sugar. Nuun contains none. Actually very few endurance athletes use Gatorade or any similar products for that very reason. Also, the sugar and large amounts of citric acid can cause massive stomach discomfort.

Many leaves and roots are high in nitrate, which can be reduced to nitrite and NO. Many plant leaves have nitrate and nitrite reductases. NO does inhibit quorum sensing by Pseudomonas and prevents the formation of a biofilm which is one of the major virulence factors.

My favorite burn and wound treatment is a culture of the ammonia oxidizing bacteria that I am working with. They are obligate autotrophs, so they can’t metabolize any animal compounds except ammonia. They generate NO and nitrite which suppresses quorum sensing. In the event there is growth of any heterotrophic bacteria, they generate NH3 from protein deamination and the ammonia oxidizers turn that into NO and nitrite, exactly where it is needed.

A wound doesn’t need to be sterile to be not infected, if the bacteria present are not expressing virulence factors, then bacteria can be tolerated. It is only when virulence factors are expressed that there is an infection. Without virulence factors there is colonization without infection.

This doesn’t address the burning issue of sports drinks, but honey is a marvelous source of Clostridium and Bacillus spores.

Parents of newborns are usually told by their pediatrician not to give honey to their infant, since the newborn’s stomach does not secrete enough acid to neutralize the spores, which can then germinate in the intestines, causing – among other things – infantile botulism (Clostridium botulinum.

Other wound-loving Clostridia include Clostridium perfringens (causative agent of “gas gangrene”) and Clostridium tetani (tetanus). The dead tissue of a serious burn would be the perfect environment for these organisms.

Still, I’d be interested to see if this remedy offers any improvement over the current standard of care for burns that can be treated at home. “Testimonials” about how this remedy healed someone’s burn faster and without scarring is less than convincing without data showing that they would have scarred and would have healed slower without the salve. That’s why we do animal studies.

I’m also concerned that anybody – with or without legitimate medical training – would try at-home treatment of second- or third-degree burns large enough to cause clinically significant dehydration. This is definitely a “don’t try this at home” situation.

People who do try to treat serious and/or large burns at home – especially burned children – are malpracticing without a license and should be prosecuted if (when?) their efforts go awry.

I completely agree with Prometheus. In my opinion, any serious or large or 3rd degree burn requires professional treatment. I did not mean to imply that the use of my bacteria was a substitute for that.

His point about Clostridia and honey is very well taken. It turns out that the Clostridia are exquisitely sensitive to NO, and is the reason that meat is cured with nitrite. The nitrite generates NO, and forms nitrosyl heme which has the characteristic red color of cured meat.

There are reports of a folk remedy that some native people use to apply to the umbilical cord of newborns, a mixture of dung and mud. This is to prevent tetanus. I have seen reports of this in the literature out of Africa and India. A friend who was from Africa and is now a midwife in a major US city reported to me that her mother talked of a tribe she was aware of that had this practice. I think it is the nitrite from ammonia oxidizing bacteria in the soil acting on NH3 from hydrolyzed urea from serum that suppresses the Clostridia.

Ordinary water, aka “free water,” goes into all three spots equally. Salt water increases intravascular volume primarily, which is what you want when you’re dehydrated. Sugar water is just like free water, as the cells in your body gobble up the sugar in short order.

Tap water + salty snack is likely just as effective for hydration as an expensive sports drink, provided there’s nothing wrong with your stomach.

Burdock is usually taken to improve liver function and can help with dermatitis/skin conditions, although my understanding of its use is that it’s supposed to be ingested, rather than applied. I’m just paraphrasing–I don’t quite trust plants that are big enough to eat you

My main gripe is about the “systematic review”. First of all, it wasn’t all that systematic–there were only two research groups which the study was able to use, seven papers they could review–and six of them were from the same group. Hardly a systematic review, if you ask me. Secondly, the results are quite clear–honey works quite well against burns and wounds. It accelerates healing and decreases infection. The review’s cautious conclusion was based on the fact that 6 of 7 papers were from the same group, and that there weren’t any quality studies done on this topic at all. Nor was there any systematic study addressing the use of sugar pastes in wounds, and comparing that with honey. Neither was there any study comparing honey to conventional burn treatments. One more time: absence of evidence is not evidence of absence, and the discussion section is actually a lot more positive than the abstract’s conclusion.

My own experience with honey is that it works as well as neosporin, and it’s a hell of a lot easier to find–jar in cupboard, versus little teeny tiny tube lost in a drawer full of crap. It’s a bit messy, and you do have to reapply every few hours, but it really does work well and it is, in fact, pretty painless. Of course, I would never recommend it for treating 3rd degree burns or anything more serious than a nick with a knife (what I usually use it for), but for a day when you run out of neosporin? Yeah, sure, why not? Plus, it greatly reduces scarring: every wound that I’ve ever treated with honey has never scarred, whereas every wound that I’ve just kept clean has left a nice little line on my hand (yes, I am that clumsy with a knife, that I have controls on the same hand ). Not really going to insist that you believe that, though.

Incidentally, I’ve only ever used pasteurised honey. The raw stuff is too tasty to be used as wound dressings

I have the New Concept in Treating Burns which is very interesting. I also have Burn Aid and Comfort for the Burned and Wounded by John Keim.

On how John Keim decided on the ingredients and how much of each for the B&W ointment he goes over that in the change “Dressing the Burns” where it discusses each ingredient and what he feels like it does.

Concerning why he added comfrey he states that “Comfrey root promotes rapid reproduction of cells.” Also Dr. Christopher’s BF&C Powder contains comfrey. (See the warning at the bottom of the above linked page — “Warning: Contains Comfrey. For external use only. Do not use if pregnant or nursing.”)

Here is an account I posted on my blog on how Burdock Leaves are used in burn treatment.

Also you may be interested in the account of how John Keim discovered the use of leaves to treat burns.

I have been posted lots of information on this in my Burn Treatments category and I would like you to take a look at it and let me know what you think.